Active NPI
Kevin Bryant Patterson
- Mental Health Counselor
- Centralia, WA
National Provider Identifier
1164089132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CG60944441
- Practice address
- 3510 Steelhammer Dr
Centralia, WA 98531-4551 - Phone
- (360) 623-8020
- NPI assigned
- May 24, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CG60944441 | WA | Primary |
Addresses
Primary practice location
3510 Steelhammer Dr
Centralia, WA 98531-4551
Mailing address
3510 Steelhammer Dr
Centralia, WA 98531-4551
Phone (360) 623-8020
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pattersonk@cascadementalhealth.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CG60944441 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cascade Community Healthcare | Mental Health | Past | Accepting new patients |
| Cascade Evaluation and Treatment Center | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Centralia, WA
- NPI 1619068624
Mental Health
-
- Mental Illness Community Based Residential Treatment Facility
- Centralia, WA
- NPI 1760979298
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652918400000",
"number": "1164089132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3510 STEELHAMMER DR",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985314551",
"telephone_number": "360-623-8020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3510 STEELHAMMER DR",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985314551",
"telephone_number": "360-623-8020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "KEVIN",
"middle_name": "BRYANT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-24",
"last_updated": "2022-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "CG60944441",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "pattersonk@cascadementalhealth.org",
"affiliation": "N",
"endpointDescription": "N/A",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "N/A",
"address_1": "3510 Steelhammer Dr",
"city": "Centralia",
"state": "WA",
"country_code": "US",
"postal_code": "985314551",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Centralia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.